Chicago 'behind the times' in heart attack response

September 01, 2009

If you're struck by crushing chest pain in Los Angeles or Boston and call 911, an ambulance will bring equipment that can tell if you're having a "widow maker" heart attack -- the most consistently deadly kind.

The information allows paramedics to alert hospitals immediately so doctors can prepare to administer potentially lifesaving treatments soon after you arrive.

That's how it works in many U.S. cities and many Chicago-area suburbs, from Aurora to Cicero to Waukegan. But not in Chicago.

None of the Chicago Fire Department's 75 ambulances carries equipment that can identify "widow maker" heart attacks, or STEMIs, which occur when a major artery supplying blood to the heart is largely or completely blocked.

As a result, medical experts say, treatment is often delayed, increasing the chances that the patient will suffer permanent heart damage or die.

"The ugly truth is that Chicago is behind the times" on its emergency response, said Dr. John Kao, director of cardiology at the Jesse Brown Veterans Affairs Medical Center in Chicago. "We are doing a disservice to our patients."

The cost of buying the diagnostic equipment, called 12-lead EKGs, and training Chicago paramedics to use it is estimated at $4 million, less than 1 percent of the Fire Department's annual budget.

Chicago fire officials say they plan to buy the equipment when it can be incorporated into a broader plan for improving emergency medical services for patients with STEMI heart attacks.

Medical experts disagree, noting that because Chicago paramedics can't determine which people are having the potentially deadly heart attacks, hospitals can't mobilize the appropriate treatment in advance.

"There's no question that patients are sometimes compromised," said Dr. Richard Feldman, a medical director for part of Chicago's EMS system who is based at Advocate Illinois Masonic Medical Center.

For every 30-minute delay in treatment, the risk of dying from a STEMI heart attack rises substantially, said Dr. Peter Kerwin, who directs the cardiac catheterization laboratory at Advocate Good Samaritan Hospital in Downers Grove.